The use of acute hemodilution in parturients undergoing cesarean section.
OBJECTIVE
Concern over transmissible disease has increased interest in methods of minimizing homologous blood transfusion during elective surgery. One method is acute hemodilution, a technique previously unreported in parturients. This study was designed to determine its feasibility and safety in women at risk of hemorrhage during cesarean section.


METHODS
This technique was performed on 38 parturients. Collected blood was retransfused at the end of surgery or earlier, if required. Hemoglobin was measured before hemodilution, after hemodilution, before transfusion, after transfusion, and 24 hours postoperatively. Neonatal assessment included umbilical blood gases and Apgar scores.


RESULTS
All patients were hemodynamically stable and no fetal heart rate abnormalities were observed during the procedure. One patient received homologous blood and 14 received previously donated autologous blood. Umbilical blood gases were normal and 5-minute Apgar scores were > or = 7.


CONCLUSIONS
This study suggests that acute hemodilution is well tolerated in parturients undergoing cesarean section. This may limit exposure to homologous blood transfusion.
Grange
C S
CS
Department of Anaesthesia, University of British Columbia, Vancouver, Canada.
Douglas
M J
MJ
Adams
T J
TJ
Wadsworth
L D
LD
D000328:Adult; D001804:Blood Transfusion, Autologous; D002585:Cesarean Section / Q000009:adverse effects*; D005260:Female; D006438:Hemodilution / Q000379:methods / Q000592:standards*; D006454:Hemoglobins / Q000032:analysis; D006470:Hemorrhage / Q000453:epidemiology* / Q000517:prevention & control*; D006801:Humans; D008875:Middle Aged; D011247:Pregnancy / Q000097:blood*; D011256:Pregnancy Outcome; D011300:Preoperative Care; D012307:Risk Factors
D006454:Hemoglobins